2022 年第 3 期 第 17 卷

基于数据挖掘探讨精准医学指导下乳腺癌分型论治的中医临床规律

Study on clinical rules of traditional Chinese medicine syndrome differentiation and treatment for breast cancer under the guidance of precision medicine based on date mining

作者：常磊1卢雯平2

英文作者：Chang Lei1 Lu Wenping2

单位：1北京中医药大学研究生院，北京100029；2中国中医科学院广安门医院肿瘤科，北京100053

英文单位：1Graduate School Beijing University of Chinese Medicine Beijing 100029 China; 2Department of Oncology Guang′anmen Hospital China Academy of Chinese Medical Sciences Beijing 100053 China

关键词：乳腺癌；分型论治；中西医融合；数据挖掘

英文关键词：Breastcancer;Syndromdifferentiationandtreatment;IntegrationofChineseandwesternmedicine;Datemining

• 摘要：

• 目的 通过数据挖掘归纳精准医学指导下乳腺癌分型论治的中医临床规律。方法  以中国知网、万方数据库、维普数据库为检索源检索中医药干预不同分子分型乳腺癌的相关文献，运用Excel软件将文献涉及辨证按分子分型进行分类汇总。使用SPSS 20.0统计软件进行中医处方数据挖掘。结果 Luminal型、三阴性、人表皮生长因子受体2(HER-2)过表达型乳腺癌排名前4位的中医证型均含肝肾阴虚证、气滞证、血瘀证，归纳其病理因素为虚、滞、瘀。Luminal型乳腺癌中以肝肾阴虚证最多见；三阴性乳腺癌中以气滞血瘀证最多见；HER-2过表达型乳腺癌中以肾虚血瘀证最多见。在治疗上，Luminal型和三阴性乳腺癌均以疏肝健脾、补益肾气为基本治则。Luminal型重视疏肝益肾；三阴性更重化痰活血、清热解毒散结；HER-2过表达型相关文献不足，无法进行聚类分析。结论  不同分子分型乳腺癌具有不同的证候特点和用药特点，精准医学指导下的中医临床选方可丰富辨病论治的内涵，指导临床实践。

• Objective   To summarize the clinical rules of Traditional Chinese Medicine (TCM) syndrome differentiation and treatment for breast cancer under the guidance of precision medicine based on data mining. Methods   China National Knowledge Infrastructure, Wanfang Database and China Science and Technology Journal Database were used to retrieve relevant literature on the intervention of TCM in different molecular types of breast cancer. Excel software was used to summarize the common TCM syndrome types of various molecular types and data mining of Chinese medicine prescriptions was performed on SPSS 20.0 software. Results  The top four TCM syndrome types of Luminal type, triple-negative type, and human epidermal growth factor receptor-2 (HER-2) overexpression type breast cancer all included liver and kidney Yin deficiency syndrome, Qi stagnation syndrome, and blood stasis syndrome, and the pathological factors were deficiency, stagnation and stasis, respectively. Liver and kidney Yin deficiency syndrome was the most common of Luminal type, Qi stagnation and blood stasis syndrome was the most common of triple-negative type, and kidney deficiency and blood stasis syndrome was the most common of HER-2 overexpression type. Soothing the liver, strengthening the spleen, and replenishing kidney Qi were basic curative rules for both Luminal and triple-negative breast cancer. Luminal type emphasizes soothing liver and tonifying kidney. Triple-negative type should be focused on reducing phlegm, promoting blood circulation, clearing away heat, detoxify and dispeling congestion. There was insufficient literature on HER-2 over expression type to perform cluster analysis. Conclusions Different molecular types of breast cancer have different syndrome characteristics and medication characteristics. Clinical application of traditional Chinese medicine for breast cancer under the guidance of precision medicine can refine this link of disease differentiation and guide clinical practice.